
<br />
<form name="personalForm" id="personalForm">

	<table>
		<tr>
			<td colspan="3"><h5>Information as Displayed in your
					Passport</h5></td>
		</tr>
		<tr>
			<td>(Given) First Name(s)</td>
			<td>:</td>
			<td><input type="text" name="firstName" id="firstName" value="${personalInformaion.firstName }"
				class="text" maxlength="40" /></td>
		</tr>
		<tr>
			<td>Middle Name(s)</td>
			<td>:</td>
			<td><input type="text" name="middleName" id="middleName"
				value="${personalInformaion.middleName }" class="text" maxlength="40" /></td>
		</tr>
		<tr>
			<td>(Family)&#32;Legal Surname(s)</td>
			<td>:</td>
			<td><input type="text" name="lastName" id="lastName" value="${personalInformaion.lastName }"
				class="text" maxlength="40" /></td>
		</tr>
		<tr>
			<td>Country of Citizenship</td>
			<td>:</td>
			<td><select name="citizenship" id="citizenship"
				style="width: 200;" 
				onChange="setUpTextboxes(this,'othCitizenCountry');">
					<option value="Select">Select a Country</option>
					<option value="other">Not on List</option>
					<option value="Afghanistan">Afghanistan</option>
					<option value="Albania">Albania</option>
					<option value="Algeria">Algeria</option>
					<option value="American Samoa">American Samoa</option>
					<option value="Andorra">Andorra</option>
					<option value="Angola">Angola</option>
					<option value="Anguilla">Anguilla</option>
					<option value="Antarctica">Antarctica</option>
					<option value="Antigua And Barbuda">Antigua And Barbuda</option>
					<option value="Argentina">Argentina</option>
					<option value="Armenia">Armenia</option>
					<option value="Aruba">Aruba</option>
					<option value="Australia">Australia</option>
					<option value="Austria">Austria</option>
					<option value="Azerbaijan">Azerbaijan</option>
					<option value="Bahamas">Bahamas</option>
					<option value="Bahrain">Bahrain</option>
					<option value="Bangladesh">Bangladesh</option>
					<option value="Barbados">Barbados</option>
					<option value="Belarus">Belarus</option>
					<option value="Belgium">Belgium</option>
					<option value="Belize">Belize</option>
					<option value="Benin">Benin</option>
					<option value="Bermuda">Bermuda</option>
					<option value="Bhutan">Bhutan</option>
					<option value="Bolivia">Bolivia</option>
					<option value="Bosnia and Herzegowina">Bosnia and
						Herzegowina</option>
					<option value="Botswana">Botswana</option>
					<option value="Bouvet Island">Bouvet Island</option>
					<option value="Brazil">Brazil</option>
					<option value="British Indian Ocean Territory">British
						Indian Ocean Territory</option>
					<option value="Brunei Darussalam">Brunei Darussalam</option>
					<option value="Bulgaria">Bulgaria</option>
					<option value="Burkina Faso">Burkina Faso</option>
					<option value="Burundi">Burundi</option>
					<option value="Cambodia">Cambodia</option>
					<option value="Cameroon">Cameroon</option>
					<option value="Canada">Canada</option>
					<option value="Cape Verde">Cape Verde</option>
					<option value="Cayman Islands">Cayman Islands</option>
					<option value="Central African Republic">Central African
						Republic</option>
					<option value="Chad">Chad</option>
					<option value="Chile">Chile</option>
					<option value="China">China</option>
					<option value="Christmas Island">Christmas Island</option>
					<option value="Cocos (keeling) Islands">Cocos (keeling)
						Islands</option>
					<option value="Colombia">Colombia</option>
					<option value="Comoros">Comoros</option>
					<option value="Congo">Congo</option>
					<option value="Cook Islands">Cook Islands</option>
					<option value="Costa Rica">Costa Rica</option>
					<option value="Cote Divoire">Cote Divoire</option>
					<option value="Croatia">Croatia</option>
					<option value="Cuba">Cuba</option>
					<option value="Cyprus">Cyprus</option>
					<option value="Czech Republic">Czech Republic</option>
					<option value="Denmark">Denmark</option>
					<option value="Djibouti">Djibouti</option>
					<option value="Dominica">Dominica</option>
					<option value="Dominican Republic">Dominican Republic</option>
					<option value="East Timor">East Timor</option>
					<option value="Ecuador">Ecuador</option>
					<option value="Egypt">Egypt</option>
					<option value="El Salvador">El Salvador</option>
					<option value="Equatorial Guinea">Equatorial Guinea</option>
					<option value="Eritrea">Eritrea</option>
					<option value="Estonia">Estonia</option>
					<option value="Ethiopia">Ethiopia</option>
					<option value="Falkland Islands">Falkland Islands</option>
					<option value="Faroe Islands">Faroe Islands</option>
					<option value="Fiji">Fiji</option>
					<option value="Finland">Finland</option>
					<option value="France">France</option>
					<option value="France, Metropolitan">France, Metropolitan</option>
					<option value="French Guiana">French Guiana</option>
					<option value="French Polynesia">French Polynesia</option>
					<option value="French Southern">French Southern</option>
					<option value="Gabon">Gabon</option>
					<option value="Gambia">Gambia</option>
					<option value="Georgia">Georgia</option>
					<option value="Germany">Germany</option>
					<option value="Ghana">Ghana</option>
					<option value="Gibraltar">Gibraltar</option>
					<option value="Greece">Greece</option>
					<option value="Greenland">Greenland</option>
					<option value="Grenada">Grenada</option>
					<option value="Guadeloupe">Guadeloupe</option>
					<option value="Guam">Guam</option>
					<option value="Guatemala">Guatemala</option>
					<option value="Guinea">Guinea</option>
					<option value="Guinea-bissau">Guinea-bissau</option>
					<option value="Guyana">Guyana</option>
					<option value="Haiti">Haiti</option>
					<option value="Heard And Mc Donald">Heard And Mc Donald</option>
					<option value="Honduras">Honduras</option>
					<option value="Hong Kong">Hong Kong</option>
					<option value="Hungary">Hungary</option>
					<option value="Iceland">Iceland</option>
					<option value="India">India</option>
					<option value="Indonesia">Indonesia</option>
					<option value="Iran">Iran</option>
					<option value="Iraq">Iraq</option>
					<option value="Ireland">Ireland</option>
					<option value="Israel">Israel</option>
					<option value="Italy">Italy</option>
					<option value="Jamaica">Jamaica</option>
					<option value="Japan">Japan</option>
					<option value="Jordan">Jordan</option>
					<option value="Kazakhstan">Kazakhstan</option>
					<option value="Kenya">Kenya</option>
					<option value="Kiribati">Kiribati</option>
					<option value="Korea">Korea</option>
					<option value="Kuwait">Kuwait</option>
					<option value="Kyrgyzstan">Kyrgyzstan</option>
					<option value="Lao People's">Lao People's</option>
					<option value="Latvia">Latvia</option>
					<option value="Lebanon">Lebanon</option>
					<option value="Lesotho">Lesotho</option>
					<option value="Liberia">Liberia</option>
					<option value="Libyan Arab Jamahiriya">Libyan Arab
						Jamahiriya</option>
					<option value="Liechtenstein">Liechtenstein</option>
					<option value="Lithuania">Lithuania</option>
					<option value="Luxembourg">Luxembourg</option>
					<option value="Macau">Macau</option>
					<option value="Macedonia">Macedonia</option>
					<option value="Madagascar">Madagascar</option>
					<option value="Malawi">Malawi</option>
					<option value="Malaysia">Malaysia</option>
					<option value="Maldives">Maldives</option>
					<option value="Mali">Mali</option>
					<option value="Malta">Malta</option>
					<option value="Marshall Islands">Marshall Islands</option>
					<option value="Martinique">Martinique</option>
					<option value="Mauritania">Mauritania</option>
					<option value="Mauritius">Mauritius</option>
					<option value="Mayotte">Mayotte</option>
					<option value="Mexico">Mexico</option>
					<option value="Micronesia">Micronesia</option>
					<option value="Moldova, Republic">Moldova, Republic</option>
					<option value="Monaco">Monaco</option>
					<option value="Mongolia">Mongolia</option>
					<option value="Montserrat">Montserrat</option>
					<option value="Morocco">Morocco</option>
					<option value="Mozambique">Mozambique</option>
					<option value="Myanmar">Myanmar</option>
					<option value="Namibia">Namibia</option>
					<option value="Nauru">Nauru</option>
					<option value="Nepal">Nepal</option>
					<option value="Netherlands">Netherlands</option>
					<option value="Netherlands Antilles">Netherlands Antilles</option>
					<option value="New Caledonia">New Caledonia</option>
					<option value="New Zealand">New Zealand</option>
					<option value="Nicaragua">Nicaragua</option>
					<option value="Niger">Niger</option>
					<option value="Nigeria">Nigeria</option>
					<option value="Niue">Niue</option>
					<option value="Norfolk Island">Norfolk Island</option>
					<option value="Northern Mariana Islands">Northern Mariana
						Islands</option>
					<option value="Norway">Norway</option>
					<option value="Oman">Oman</option>
					<option value="Pakistan">Pakistan</option>
					<option value="Palau">Palau</option>
					<option value="Palestine (West Bank)">Palestine (West
						Bank)</option>
					<option value="Palestine (Gaza strip)">Palestine (Gaza
						strip)</option>
					<option value="Panama">Panama</option>
					<option value="Papua New Guinea">Papua New Guinea</option>
					<option value="Paraguay">Paraguay</option>
					<option value="Peru">Peru</option>
					<option value="Philippines">Philippines</option>
					<option value="Pitcairn">Pitcairn</option>
					<option value="Poland">Poland</option>
					<option value="Portugal">Portugal</option>
					<option value="Puerto Rico">Puerto Rico</option>
					<option value="Qatar">Qatar</option>
					<option value="Reunion">Reunion</option>
					<option value="Romania">Romania</option>
					<option value="Russian Federation">Russian Federation</option>
					<option value="Rwanda">Rwanda</option>
					<option value="Saint Kitts And Nevis">Saint Kitts And
						Nevis</option>
					<option value="Saint Lucia">Saint Lucia</option>
					<option value="Saint Vincent">Saint Vincent</option>
					<option value="Samoa">Samoa</option>
					<option value="San Marino">San Marino</option>
					<option value="Sao Tome And Principe">Sao Tome And
						Principe</option>
					<option value="Saudi Arabia">Saudi Arabia</option>
					<option value="Senegal">Senegal</option>
					<option value="Seychelles">Seychelles</option>
					<option value="Sierra Leone">Sierra Leone</option>
					<option value="Singapore">Singapore</option>
					<option value="Slovakia (Slovak Republic)">Slovakia
						(Slovak Republic)</option>
					<option value="Slovenia">Slovenia</option>
					<option value="Solomon Islands">Solomon Islands</option>
					<option value="Somalia">Somalia</option>
					<option value="South Africa">South Africa</option>
					<option value="South Georgia">South Georgia</option>
					<option value="Spain">Spain</option>
					<option value="Sri Lanka">Sri Lanka</option>
					<option value="St. Helena">St. Helena</option>
					<option value="St. Pierre And Miquelon">St. Pierre And
						Miquelon</option>
					<option value="Sudan">Sudan</option>
					<option value="Suriname">Suriname</option>
					<option value="Svalbard Islands">Svalbard Islands</option>
					<option value="Swaziland">Swaziland</option>
					<option value="Sweden">Sweden</option>
					<option value="Switzerland">Switzerland</option>
					<option value="Syrian Arab Republic">Syrian Arab Republic</option>
					<option value="Taiwan">Taiwan</option>
					<option value="Tajikistan">Tajikistan</option>
					<option value="Tanzania">Tanzania</option>
					<option value="Thailand">Thailand</option>
					<option value="Togo">Togo</option>
					<option value="Tokelau">Tokelau</option>
					<option value="Tonga">Tonga</option>
					<option value="Trinidad And Tobago">Trinidad And Tobago</option>
					<option value="Tunisia">Tunisia</option>
					<option value="Turkey">Turkey</option>
					<option value="Turkmenistan">Turkmenistan</option>
					<option value="Turks And Caicos Islands">Turks And Caicos
						Islands</option>
					<option value="Tuvalu">Tuvalu</option>
					<option value="Uganda">Uganda</option>
					<option value="Ukraine">Ukraine</option>
					<option value="United Arab Emirates">United Arab Emirates</option>
					<option value="United Kingdom">United Kingdom</option>
					<option value="United States">United States</option>
					<option value="Uruguay">Uruguay</option>
					<option value="Uzbekistan">Uzbekistan</option>
					<option value="Vanuatu">Vanuatu</option>
					<option value="Vatican City State (holy See)">Vatican City
						State (holy See)</option>
					<option value="Venezuela">Venezuela</option>
					<option value="Viet Nam">Viet Nam</option>
					<option value="Virgin Islands (British)">Virgin Islands
						(British)</option>
					<option value="Virgin Islands (U.S.)">Virgin Islands
						(U.S.)</option>
					<option value="Wallis And Futuna Islands">Wallis And
						Futuna Islands</option>
					<option value="Western Sahara">Western Sahara</option>
					<option value="Yemen">Yemen</option>
					<option value="Yugoslavia">Yugoslavia</option>
					<option value="Zaire">Zaire</option>
					<option value="Zambia">Zambia</option>
					<option value="Zimbabwe">Zimbabwe</option>
			</select></td>
		</tr>
		<tr>
			<td>If 'Not on List'</td>
			<td>:</td>
			<td><input type="text" name="othCitizenCountry"
				id="othCitizenCountry" disabled style="background-color: #e0e0e0;"
				class="text" maxlength="40" value="${personalInformaion.othCitizenCountry }"/></td>
		</tr>
		<tr>
			<td>Country of Birth</td>
			<td>:</td>
			<td><select name="birthCountry" id="birthCountry"
				style="width: 200;"
				onChange="setUpTextboxes(this,'othBirthCountry');">
					<option value="Select">Select a Country</option>
					<option value="other">Not on List</option>
					<option value="Afghanistan">Afghanistan</option>
					<option value="Albania">Albania</option>
					<option value="Algeria">Algeria</option>
					<option value="American Samoa">American Samoa</option>
					<option value="Andorra">Andorra</option>
					<option value="Angola">Angola</option>
					<option value="Anguilla">Anguilla</option>
					<option value="Antarctica">Antarctica</option>
					<option value="Antigua And Barbuda">Antigua And Barbuda</option>
					<option value="Argentina">Argentina</option>
					<option value="Armenia">Armenia</option>
					<option value="Aruba">Aruba</option>
					<option value="Australia">Australia</option>
					<option value="Austria">Austria</option>
					<option value="Azerbaijan">Azerbaijan</option>
					<option value="Bahamas">Bahamas</option>
					<option value="Bahrain">Bahrain</option>
					<option value="Bangladesh">Bangladesh</option>
					<option value="Barbados">Barbados</option>
					<option value="Belarus">Belarus</option>
					<option value="Belgium">Belgium</option>
					<option value="Belize">Belize</option>
					<option value="Benin">Benin</option>
					<option value="Bermuda">Bermuda</option>
					<option value="Bhutan">Bhutan</option>
					<option value="Bolivia">Bolivia</option>
					<option value="Bosnia and Herzegowina">Bosnia and
						Herzegowina</option>
					<option value="Botswana">Botswana</option>
					<option value="Bouvet Island">Bouvet Island</option>
					<option value="Brazil">Brazil</option>
					<option value="British Indian Ocean Territory">British
						Indian Ocean Territory</option>
					<option value="Brunei Darussalam">Brunei Darussalam</option>
					<option value="Bulgaria">Bulgaria</option>
					<option value="Burkina Faso">Burkina Faso</option>
					<option value="Burundi">Burundi</option>
					<option value="Cambodia">Cambodia</option>
					<option value="Cameroon">Cameroon</option>
					<option value="Canada">Canada</option>
					<option value="Cape Verde">Cape Verde</option>
					<option value="Cayman Islands">Cayman Islands</option>
					<option value="Central African Republic">Central African
						Republic</option>
					<option value="Chad">Chad</option>
					<option value="Chile">Chile</option>
					<option value="China">China</option>
					<option value="Christmas Island">Christmas Island</option>
					<option value="Cocos (keeling) Islands">Cocos (keeling)
						Islands</option>
					<option value="Colombia">Colombia</option>
					<option value="Comoros">Comoros</option>
					<option value="Congo">Congo</option>
					<option value="Cook Islands">Cook Islands</option>
					<option value="Costa Rica">Costa Rica</option>
					<option value="Cote Divoire">Cote Divoire</option>
					<option value="Croatia">Croatia</option>
					<option value="Cuba">Cuba</option>
					<option value="Cyprus">Cyprus</option>
					<option value="Czech Republic">Czech Republic</option>
					<option value="Denmark">Denmark</option>
					<option value="Djibouti">Djibouti</option>
					<option value="Dominica">Dominica</option>
					<option value="Dominican Republic">Dominican Republic</option>
					<option value="East Timor">East Timor</option>
					<option value="Ecuador">Ecuador</option>
					<option value="Egypt">Egypt</option>
					<option value="El Salvador">El Salvador</option>
					<option value="Equatorial Guinea">Equatorial Guinea</option>
					<option value="Eritrea">Eritrea</option>
					<option value="Estonia">Estonia</option>
					<option value="Ethiopia">Ethiopia</option>
					<option value="Falkland Islands">Falkland Islands</option>
					<option value="Faroe Islands">Faroe Islands</option>
					<option value="Fiji">Fiji</option>
					<option value="Finland">Finland</option>
					<option value="France">France</option>
					<option value="France, Metropolitan">France, Metropolitan</option>
					<option value="French Guiana">French Guiana</option>
					<option value="French Polynesia">French Polynesia</option>
					<option value="French Southern">French Southern</option>
					<option value="Gabon">Gabon</option>
					<option value="Gambia">Gambia</option>
					<option value="Georgia">Georgia</option>
					<option value="Germany">Germany</option>
					<option value="Ghana">Ghana</option>
					<option value="Gibraltar">Gibraltar</option>
					<option value="Greece">Greece</option>
					<option value="Greenland">Greenland</option>
					<option value="Grenada">Grenada</option>
					<option value="Guadeloupe">Guadeloupe</option>
					<option value="Guam">Guam</option>
					<option value="Guatemala">Guatemala</option>
					<option value="Guinea">Guinea</option>
					<option value="Guinea-bissau">Guinea-bissau</option>
					<option value="Guyana">Guyana</option>
					<option value="Haiti">Haiti</option>
					<option value="Heard And Mc Donald">Heard And Mc Donald</option>
					<option value="Honduras">Honduras</option>
					<option value="Hong Kong">Hong Kong</option>
					<option value="Hungary">Hungary</option>
					<option value="Iceland">Iceland</option>
					<option value="India">India</option>
					<option value="Indonesia">Indonesia</option>
					<option value="Iran">Iran</option>
					<option value="Iraq">Iraq</option>
					<option value="Ireland">Ireland</option>
					<option value="Israel">Israel</option>
					<option value="Italy">Italy</option>
					<option value="Jamaica">Jamaica</option>
					<option value="Japan">Japan</option>
					<option value="Jordan">Jordan</option>
					<option value="Kazakhstan">Kazakhstan</option>
					<option value="Kenya">Kenya</option>
					<option value="Kiribati">Kiribati</option>
					<option value="Korea">Korea</option>
					<option value="Kuwait">Kuwait</option>
					<option value="Kyrgyzstan">Kyrgyzstan</option>
					<option value="Lao People's">Lao People's</option>
					<option value="Latvia">Latvia</option>
					<option value="Lebanon">Lebanon</option>
					<option value="Lesotho">Lesotho</option>
					<option value="Liberia">Liberia</option>
					<option value="Libyan Arab Jamahiriya">Libyan Arab
						Jamahiriya</option>
					<option value="Liechtenstein">Liechtenstein</option>
					<option value="Lithuania">Lithuania</option>
					<option value="Luxembourg">Luxembourg</option>
					<option value="Macau">Macau</option>
					<option value="Macedonia">Macedonia</option>
					<option value="Madagascar">Madagascar</option>
					<option value="Malawi">Malawi</option>
					<option value="Malaysia">Malaysia</option>
					<option value="Maldives">Maldives</option>
					<option value="Mali">Mali</option>
					<option value="Malta">Malta</option>
					<option value="Marshall Islands">Marshall Islands</option>
					<option value="Martinique">Martinique</option>
					<option value="Mauritania">Mauritania</option>
					<option value="Mauritius">Mauritius</option>
					<option value="Mayotte">Mayotte</option>
					<option value="Mexico">Mexico</option>
					<option value="Micronesia">Micronesia</option>
					<option value="Moldova, Republic">Moldova, Republic</option>
					<option value="Monaco">Monaco</option>
					<option value="Mongolia">Mongolia</option>
					<option value="Montserrat">Montserrat</option>
					<option value="Morocco">Morocco</option>
					<option value="Mozambique">Mozambique</option>
					<option value="Myanmar">Myanmar</option>
					<option value="Namibia">Namibia</option>
					<option value="Nauru">Nauru</option>
					<option value="Nepal">Nepal</option>
					<option value="Netherlands">Netherlands</option>
					<option value="Netherlands Antilles">Netherlands Antilles</option>
					<option value="New Caledonia">New Caledonia</option>
					<option value="New Zealand">New Zealand</option>
					<option value="Nicaragua">Nicaragua</option>
					<option value="Niger">Niger</option>
					<option value="Nigeria">Nigeria</option>
					<option value="Niue">Niue</option>
					<option value="Norfolk Island">Norfolk Island</option>
					<option value="Northern Mariana Islands">Northern Mariana
						Islands</option>
					<option value="Norway">Norway</option>
					<option value="Oman">Oman</option>
					<option value="Pakistan">Pakistan</option>
					<option value="Palau">Palau</option>
					<option value="Palestine (West Bank)">Palestine (West
						Bank)</option>
					<option value="Palestine (Gaza strip)">Palestine (Gaza
						strip)</option>
					<option value="Panama">Panama</option>
					<option value="Papua New Guinea">Papua New Guinea</option>
					<option value="Paraguay">Paraguay</option>
					<option value="Peru">Peru</option>
					<option value="Philippines">Philippines</option>
					<option value="Pitcairn">Pitcairn</option>
					<option value="Poland">Poland</option>
					<option value="Portugal">Portugal</option>
					<option value="Puerto Rico">Puerto Rico</option>
					<option value="Qatar">Qatar</option>
					<option value="Reunion">Reunion</option>
					<option value="Romania">Romania</option>
					<option value="Russian Federation">Russian Federation</option>
					<option value="Rwanda">Rwanda</option>
					<option value="Saint Kitts And Nevis">Saint Kitts And
						Nevis</option>
					<option value="Saint Lucia">Saint Lucia</option>
					<option value="Saint Vincent">Saint Vincent</option>
					<option value="Samoa">Samoa</option>
					<option value="San Marino">San Marino</option>
					<option value="Sao Tome And Principe">Sao Tome And
						Principe</option>
					<option value="Saudi Arabia">Saudi Arabia</option>
					<option value="Senegal">Senegal</option>
					<option value="Seychelles">Seychelles</option>
					<option value="Sierra Leone">Sierra Leone</option>
					<option value="Singapore">Singapore</option>
					<option value="Slovakia (Slovak Republic)">Slovakia
						(Slovak Republic)</option>
					<option value="Slovenia">Slovenia</option>
					<option value="Solomon Islands">Solomon Islands</option>
					<option value="Somalia">Somalia</option>
					<option value="South Africa">South Africa</option>
					<option value="South Georgia">South Georgia</option>
					<option value="Spain">Spain</option>
					<option value="Sri Lanka">Sri Lanka</option>
					<option value="St. Helena">St. Helena</option>
					<option value="St. Pierre And Miquelon">St. Pierre And
						Miquelon</option>
					<option value="Sudan">Sudan</option>
					<option value="Suriname">Suriname</option>
					<option value="Svalbard Islands">Svalbard Islands</option>
					<option value="Swaziland">Swaziland</option>
					<option value="Sweden">Sweden</option>
					<option value="Switzerland">Switzerland</option>
					<option value="Syrian Arab Republic">Syrian Arab Republic</option>
					<option value="Taiwan">Taiwan</option>
					<option value="Tajikistan">Tajikistan</option>
					<option value="Tanzania">Tanzania</option>
					<option value="Thailand">Thailand</option>
					<option value="Togo">Togo</option>
					<option value="Tokelau">Tokelau</option>
					<option value="Tonga">Tonga</option>
					<option value="Trinidad And Tobago">Trinidad And Tobago</option>
					<option value="Tunisia">Tunisia</option>
					<option value="Turkey">Turkey</option>
					<option value="Turkmenistan">Turkmenistan</option>
					<option value="Turks And Caicos Islands">Turks And Caicos
						Islands</option>
					<option value="Tuvalu">Tuvalu</option>
					<option value="Uganda">Uganda</option>
					<option value="Ukraine">Ukraine</option>
					<option value="United Arab Emirates">United Arab Emirates</option>
					<option value="United Kingdom">United Kingdom</option>
					<option value="United States">United States</option>
					<option value="Uruguay">Uruguay</option>
					<option value="Uzbekistan">Uzbekistan</option>
					<option value="Vanuatu">Vanuatu</option>
					<option value="Vatican City State (holy See)">Vatican City
						State (holy See)</option>
					<option value="Venezuela">Venezuela</option>
					<option value="Viet Nam">Viet Nam</option>
					<option value="Virgin Islands (British)">Virgin Islands
						(British)</option>
					<option value="Virgin Islands (U.S.)">Virgin Islands
						(U.S.)</option>
					<option value="Wallis And Futuna Islands">Wallis And
						Futuna Islands</option>
					<option value="Western Sahara">Western Sahara</option>
					<option value="Yemen">Yemen</option>
					<option value="Yugoslavia">Yugoslavia</option>
					<option value="Zaire">Zaire</option>
					<option value="Zambia">Zambia</option>
					<option value="Zimbabwe">Zimbabwe</option>
			</select></td>
		</tr>

		<tr>
			<td>&nbsp;&nbsp;&nbsp;If 'Not on List'</td>
			<td>:</td>
			<td><input type="text" name="othBirthCountry"
				id="othBirthCountry" disabled style="background-color: #e0e0e0;"
				class="text" maxlength="40" value="${personalInformaion.othBirthCountry }"/></td>
		</tr>
		<tr>
			<td>Date of Birth</td>
			<td>:</td>
			<td><select name="birthmonth" id="birthmonth" style="width: 50;"
				value="">
					<option value="Jan">Jan</option>
					<option value="Feb">Feb</option>
					<option value="Mar">Mar</option>
					<option value="Apr">Apr</option>
					<option value="May">May</option>
					<option value="Jun">Jun</option>
					<option value="Jul">Jul</option>
					<option value="Aug">Aug</option>
					<option value="Sep">Sep</option>
					<option value="Oct">Oct</option>
					<option value="Nov">Nov</option>
					<option value="Dec">Dec</option>
			</select> <select name="birthday" id="birthday" style="width: 50;" value="">
					<option value="1">01</option>
					<option value="2">02</option>
					<option value="3">03</option>
					<option value="4">04</option>
					<option value="5">05</option>
					<option value="6">06</option>
					<option value="7">07</option>
					<option value="8">08</option>
					<option value="9">09</option>
					<option value="10">10</option>
					<option value="11">11</option>
					<option value="12">12</option>
					<option value="13">13</option>
					<option value="14">14</option>
					<option value="15">15</option>
					<option value="16">16</option>
					<option value="17">17</option>
					<option value="18">18</option>
					<option value="19">19</option>
					<option value="20">20</option>
					<option value="21">21</option>
					<option value="22">22</option>
					<option value="23">23</option>
					<option value="24">24</option>
					<option value="25">25</option>
					<option value="26">26</option>
					<option value="27">27</option>
					<option value="28">28</option>
					<option value="29">29</option>
					<option value="30">30</option>
					<option value="31">31</option>
			</select> <select name="birthyear" id="birthyear" style="width: 60;">
					<option value="1900">1900</option>
					<option value="1901">1901</option>
					<option value="1902">1902</option>
					<option value="1903">1903</option>
					<option value="1904">1904</option>
					<option value="1905">1905</option>
					<option value="1906">1906</option>
					<option value="1907">1907</option>
					<option value="1908">1908</option>
					<option value="1909">1909</option>
					<option value="1910">1910</option>
					<option value="1911">1911</option>
					<option value="1912">1912</option>
					<option value="1913">1913</option>
					<option value="1914">1914</option>
					<option value="1915">1915</option>
					<option value="1916">1916</option>
					<option value="1917">1917</option>
					<option value="1918">1918</option>
					<option value="1919">1919</option>
					<option value="1920">1920</option>
					<option value="1921">1921</option>
					<option value="1922">1922</option>
					<option value="1923">1923</option>
					<option value="1924">1924</option>
					<option value="1925">1925</option>
					<option value="1926">1926</option>
					<option value="1927">1927</option>
					<option value="1928">1928</option>
					<option value="1929">1929</option>
					<option value="1930">1930</option>
					<option value="1931">1931</option>
					<option value="1932">1932</option>
					<option value="1933">1933</option>
					<option value="1934">1934</option>
					<option value="1935">1935</option>
					<option value="1936">1936</option>
					<option value="1937">1937</option>
					<option value="1938">1938</option>
					<option value="1939">1939</option>
					<option value="1940">1940</option>
					<option value="1941">1941</option>
					<option value="1942">1942</option>
					<option value="1943">1943</option>
					<option value="1944">1944</option>
					<option value="1945">1945</option>
					<option value="1946">1946</option>
					<option value="1947">1947</option>
					<option value="1948">1948</option>
					<option value="1949">1949</option>
					<option value="1950">1950</option>
					<option value="1951">1951</option>
					<option value="1952">1952</option>
					<option value="1953">1953</option>
					<option value="1954">1954</option>
					<option value="1955">1955</option>
					<option value="1956">1956</option>
					<option value="1957">1957</option>
					<option value="1958">1958</option>
					<option value="1959">1959</option>
					<option value="1960">1960</option>
					<option value="1961">1961</option>
					<option value="1962">1962</option>
					<option value="1963">1963</option>
					<option value="1964">1964</option>
					<option value="1965">1965</option>
					<option value="1966">1966</option>
					<option value="1967">1967</option>
					<option value="1968">1968</option>
					<option value="1969">1969</option>
					<option value="1970">1970</option>
					<option value="1971">1971</option>
					<option value="1972">1972</option>
					<option value="1973">1973</option>
					<option value="1974">1974</option>
					<option value="1975">1975</option>
					<option value="1976">1976</option>
					<option value="1977">1977</option>
					<option value="1978">1978</option>
					<option value="1979">1979</option>
					<option value="1980" selected="selected">1980</option>
					<option value="1981">1981</option>
					<option value="1982">1982</option>
					<option value="1983">1983</option>
					<option value="1984">1984</option>
					<option value="1985">1985</option>
					<option value="1986">1986</option>
					<option value="1987">1987</option>
					<option value="1988">1988</option>
					<option value="1989">1989</option>
					<option value="1990">1990</option>
					<option value="1991">1991</option>
					<option value="1992">1992</option>
					<option value="1993">1993</option>
					<option value="1994">1994</option>
					<option value="1995">1995</option>
					<option value="1996">1996</option>
					<option value="1997">1997</option>
					<option value="1998">1998</option>
					<option value="1999">1999</option>
					<option value="2000">2000</option>
					<option value="2001">2001</option>
					<option value="2002">2002</option>
					<option value="2003">2003</option>
					<option value="2004">2004</option>
					<option value="2005">2005</option>
					<option value="2006">2006</option>
					<option value="2007">2007</option>
					<option value="2008">2008</option>
			</select>
		</tr>
		
		<tr>
			<td colspan="3"><h5>Contact Information</h5></td>
		</tr>
		<tr>
			<td>Skype ID</td>
			<td>:</td>
			<td><input type="text" name="skype" id="skype" class="text"
				value="${personalInformaion.skype }" maxlength="40" /></td>
		</tr>
		<tr>
			<td>Phone Number</td>
			<td>:</td>
			<td><input type="text" name="phone" id="phone" value="${personalInformaion.phone }"
				class="text" maxlength="40" /></td>

		</tr>
		<tr>
			<td>City you live in now</td>
			<td>:</td>
			<td><input type="text" name="city" id="city" value="${personalInformaion.city }"
				class="text" maxlength="30" /></td>
		</tr>
		<tr>
			<td>Country you live in now</td>
			<td>:</td>
			<td><select name="residence" id="residence" style="width: 200;"
				onChange="setUpTextboxes(this,'othResidCountry');">
					<option value="Select">Select a Country</option>
					<option value="other">Not on List</option>
					<option value="Afghanistan">Afghanistan</option>
					<option value="Albania">Albania</option>
					<option value="Algeria">Algeria</option>
					<option value="American Samoa">American Samoa</option>
					<option value="Andorra">Andorra</option>
					<option value="Angola">Angola</option>
					<option value="Anguilla">Anguilla</option>
					<option value="Antarctica">Antarctica</option>
					<option value="Antigua And Barbuda">Antigua And Barbuda</option>
					<option value="Argentina">Argentina</option>
					<option value="Armenia">Armenia</option>
					<option value="Aruba">Aruba</option>
					<option value="Australia">Australia</option>
					<option value="Austria">Austria</option>
					<option value="Azerbaijan">Azerbaijan</option>
					<option value="Bahamas">Bahamas</option>
					<option value="Bahrain">Bahrain</option>
					<option value="Bangladesh">Bangladesh</option>
					<option value="Barbados">Barbados</option>
					<option value="Belarus">Belarus</option>
					<option value="Belgium">Belgium</option>
					<option value="Belize">Belize</option>
					<option value="Benin">Benin</option>
					<option value="Bermuda">Bermuda</option>
					<option value="Bhutan">Bhutan</option>
					<option value="Bolivia">Bolivia</option>
					<option value="Bosnia and Herzegowina">Bosnia and
						Herzegowina</option>
					<option value="Botswana">Botswana</option>
					<option value="Bouvet Island">Bouvet Island</option>
					<option value="Brazil">Brazil</option>
					<option value="British Indian Ocean Territory">British
						Indian Ocean Territory</option>
					<option value="Brunei Darussalam">Brunei Darussalam</option>
					<option value="Bulgaria">Bulgaria</option>
					<option value="Burkina Faso">Burkina Faso</option>
					<option value="Burundi">Burundi</option>
					<option value="Cambodia">Cambodia</option>
					<option value="Cameroon">Cameroon</option>
					<option value="Canada">Canada</option>
					<option value="Cape Verde">Cape Verde</option>
					<option value="Cayman Islands">Cayman Islands</option>
					<option value="Central African Republic">Central African
						Republic</option>
					<option value="Chad">Chad</option>
					<option value="Chile">Chile</option>
					<option value="China">China</option>
					<option value="Christmas Island">Christmas Island</option>
					<option value="Cocos (keeling) Islands">Cocos (keeling)
						Islands</option>
					<option value="Colombia">Colombia</option>
					<option value="Comoros">Comoros</option>
					<option value="Congo">Congo</option>
					<option value="Cook Islands">Cook Islands</option>
					<option value="Costa Rica">Costa Rica</option>
					<option value="Cote Divoire">Cote Divoire</option>
					<option value="Croatia">Croatia</option>
					<option value="Cuba">Cuba</option>
					<option value="Cyprus">Cyprus</option>
					<option value="Czech Republic">Czech Republic</option>
					<option value="Denmark">Denmark</option>
					<option value="Djibouti">Djibouti</option>
					<option value="Dominica">Dominica</option>
					<option value="Dominican Republic">Dominican Republic</option>
					<option value="East Timor">East Timor</option>
					<option value="Ecuador">Ecuador</option>
					<option value="Egypt">Egypt</option>
					<option value="El Salvador">El Salvador</option>
					<option value="Equatorial Guinea">Equatorial Guinea</option>
					<option value="Eritrea">Eritrea</option>
					<option value="Estonia">Estonia</option>
					<option value="Ethiopia">Ethiopia</option>
					<option value="Falkland Islands">Falkland Islands</option>
					<option value="Faroe Islands">Faroe Islands</option>
					<option value="Fiji">Fiji</option>
					<option value="Finland">Finland</option>
					<option value="France">France</option>
					<option value="France, Metropolitan">France, Metropolitan</option>
					<option value="French Guiana">French Guiana</option>
					<option value="French Polynesia">French Polynesia</option>
					<option value="French Southern">French Southern</option>
					<option value="Gabon">Gabon</option>
					<option value="Gambia">Gambia</option>
					<option value="Georgia">Georgia</option>
					<option value="Germany">Germany</option>
					<option value="Ghana">Ghana</option>
					<option value="Gibraltar">Gibraltar</option>
					<option value="Greece">Greece</option>
					<option value="Greenland">Greenland</option>
					<option value="Grenada">Grenada</option>
					<option value="Guadeloupe">Guadeloupe</option>
					<option value="Guam">Guam</option>
					<option value="Guatemala">Guatemala</option>
					<option value="Guinea">Guinea</option>
					<option value="Guinea-bissau">Guinea-bissau</option>
					<option value="Guyana">Guyana</option>
					<option value="Haiti">Haiti</option>
					<option value="Heard And Mc Donald">Heard And Mc Donald</option>
					<option value="Honduras">Honduras</option>
					<option value="Hong Kong">Hong Kong</option>
					<option value="Hungary">Hungary</option>
					<option value="Iceland">Iceland</option>
					<option value="India">India</option>
					<option value="Indonesia">Indonesia</option>
					<option value="Iran">Iran</option>
					<option value="Iraq">Iraq</option>
					<option value="Ireland">Ireland</option>
					<option value="Israel">Israel</option>
					<option value="Italy">Italy</option>
					<option value="Jamaica">Jamaica</option>
					<option value="Japan">Japan</option>
					<option value="Jordan">Jordan</option>
					<option value="Kazakhstan">Kazakhstan</option>
					<option value="Kenya">Kenya</option>
					<option value="Kiribati">Kiribati</option>
					<option value="Korea">Korea</option>
					<option value="Kuwait">Kuwait</option>
					<option value="Kyrgyzstan">Kyrgyzstan</option>
					<option value="Lao People's">Lao People's</option>
					<option value="Latvia">Latvia</option>
					<option value="Lebanon">Lebanon</option>
					<option value="Lesotho">Lesotho</option>
					<option value="Liberia">Liberia</option>
					<option value="Libyan Arab Jamahiriya">Libyan Arab
						Jamahiriya</option>
					<option value="Liechtenstein">Liechtenstein</option>
					<option value="Lithuania">Lithuania</option>
					<option value="Luxembourg">Luxembourg</option>
					<option value="Macau">Macau</option>
					<option value="Macedonia">Macedonia</option>
					<option value="Madagascar">Madagascar</option>
					<option value="Malawi">Malawi</option>
					<option value="Malaysia">Malaysia</option>
					<option value="Maldives">Maldives</option>
					<option value="Mali">Mali</option>
					<option value="Malta">Malta</option>
					<option value="Marshall Islands">Marshall Islands</option>
					<option value="Martinique">Martinique</option>
					<option value="Mauritania">Mauritania</option>
					<option value="Mauritius">Mauritius</option>
					<option value="Mayotte">Mayotte</option>
					<option value="Mexico">Mexico</option>
					<option value="Micronesia">Micronesia</option>
					<option value="Moldova, Republic">Moldova, Republic</option>
					<option value="Monaco">Monaco</option>
					<option value="Mongolia">Mongolia</option>
					<option value="Montserrat">Montserrat</option>
					<option value="Morocco">Morocco</option>
					<option value="Mozambique">Mozambique</option>
					<option value="Myanmar">Myanmar</option>
					<option value="Namibia">Namibia</option>
					<option value="Nauru">Nauru</option>
					<option value="Nepal">Nepal</option>
					<option value="Netherlands">Netherlands</option>
					<option value="Netherlands Antilles">Netherlands Antilles</option>
					<option value="New Caledonia">New Caledonia</option>
					<option value="New Zealand">New Zealand</option>
					<option value="Nicaragua">Nicaragua</option>
					<option value="Niger">Niger</option>
					<option value="Nigeria">Nigeria</option>
					<option value="Niue">Niue</option>
					<option value="Norfolk Island">Norfolk Island</option>
					<option value="Northern Mariana Islands">Northern Mariana
						Islands</option>
					<option value="Norway">Norway</option>
					<option value="Oman">Oman</option>
					<option value="Pakistan">Pakistan</option>
					<option value="Palau">Palau</option>
					<option value="Palestine (West Bank)">Palestine (West
						Bank)</option>
					<option value="Palestine (Gaza strip)">Palestine (Gaza
						strip)</option>
					<option value="Panama">Panama</option>
					<option value="Papua New Guinea">Papua New Guinea</option>
					<option value="Paraguay">Paraguay</option>
					<option value="Peru">Peru</option>
					<option value="Philippines">Philippines</option>
					<option value="Pitcairn">Pitcairn</option>
					<option value="Poland">Poland</option>
					<option value="Portugal">Portugal</option>
					<option value="Puerto Rico">Puerto Rico</option>
					<option value="Qatar">Qatar</option>
					<option value="Reunion">Reunion</option>
					<option value="Romania">Romania</option>
					<option value="Russian Federation">Russian Federation</option>
					<option value="Rwanda">Rwanda</option>
					<option value="Saint Kitts And Nevis">Saint Kitts And
						Nevis</option>
					<option value="Saint Lucia">Saint Lucia</option>
					<option value="Saint Vincent">Saint Vincent</option>
					<option value="Samoa">Samoa</option>
					<option value="San Marino">San Marino</option>
					<option value="Sao Tome And Principe">Sao Tome And
						Principe</option>
					<option value="Saudi Arabia">Saudi Arabia</option>
					<option value="Senegal">Senegal</option>
					<option value="Seychelles">Seychelles</option>
					<option value="Sierra Leone">Sierra Leone</option>
					<option value="Singapore">Singapore</option>
					<option value="Slovakia (Slovak Republic)">Slovakia
						(Slovak Republic)</option>
					<option value="Slovenia">Slovenia</option>
					<option value="Solomon Islands">Solomon Islands</option>
					<option value="Somalia">Somalia</option>
					<option value="South Africa">South Africa</option>
					<option value="South Georgia">South Georgia</option>
					<option value="Spain">Spain</option>
					<option value="Sri Lanka">Sri Lanka</option>
					<option value="St. Helena">St. Helena</option>
					<option value="St. Pierre And Miquelon">St. Pierre And
						Miquelon</option>
					<option value="Sudan">Sudan</option>
					<option value="Suriname">Suriname</option>
					<option value="Svalbard Islands">Svalbard Islands</option>
					<option value="Swaziland">Swaziland</option>
					<option value="Sweden">Sweden</option>
					<option value="Switzerland">Switzerland</option>
					<option value="Syrian Arab Republic">Syrian Arab Republic</option>
					<option value="Taiwan">Taiwan</option>
					<option value="Tajikistan">Tajikistan</option>
					<option value="Tanzania">Tanzania</option>
					<option value="Thailand">Thailand</option>
					<option value="Togo">Togo</option>
					<option value="Tokelau">Tokelau</option>
					<option value="Tonga">Tonga</option>
					<option value="Trinidad And Tobago">Trinidad And Tobago</option>
					<option value="Tunisia">Tunisia</option>
					<option value="Turkey">Turkey</option>
					<option value="Turkmenistan">Turkmenistan</option>
					<option value="Turks And Caicos Islands">Turks And Caicos
						Islands</option>
					<option value="Tuvalu">Tuvalu</option>
					<option value="Uganda">Uganda</option>
					<option value="Ukraine">Ukraine</option>
					<option value="United Arab Emirates">United Arab Emirates</option>
					<option value="United Kingdom">United Kingdom</option>
					<option value="United States">United States</option>
					<option value="Uruguay">Uruguay</option>
					<option value="Uzbekistan">Uzbekistan</option>
					<option value="Vanuatu">Vanuatu</option>
					<option value="Vatican City State (holy See)">Vatican City
						State (holy See)</option>
					<option value="Venezuela">Venezuela</option>
					<option value="Viet Nam">Viet Nam</option>
					<option value="Virgin Islands (British)">Virgin Islands
						(British)</option>
					<option value="Virgin Islands (U.S.)">Virgin Islands
						(U.S.)</option>
					<option value="Wallis And Futuna Islands">Wallis And
						Futuna Islands</option>
					<option value="Western Sahara">Western Sahara</option>
					<option value="Yemen">Yemen</option>
					<option value="Yugoslavia">Yugoslavia</option>
					<option value="Zaire">Zaire</option>
					<option value="Zambia">Zambia</option>
					<option value="Zimbabwe">Zimbabwe</option>
			</select></td>
		</tr>
		<tr>
			<td>&nbsp;&nbsp;&nbsp;If 'Not on List'</td>

			<td>:</td>
			<td><input type="text" name="othResidCountry"
				id="othResidCountry" disabled style="background-color: #e0e0e0;"
				class="text" maxlength="40" value="${personalInformaion.othResidCountry }"/></td>
		</tr>
		<tr>
			<td colspan="3"><br /></td>
		</tr>
		<tr>
			<td colspan="3"><h5>MS Program</h5></td>
		</tr>
		<tr>
			<td colspan="3"><input type="radio" name="program" id="campus"
				value="campus" checked="checked"
				onclick="setUpMSProgram(this,'entry');" />Regular Program (take
				courses on Campus and Distance Education in the US)</td>
		</tr>
		<tr>
			<td colspan="3">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date
				of entry are you applying for? &nbsp;&nbsp;&nbsp; <select
				name="entry" id="entry" style="width: 175px">
					<option value="Oct2013">October 2013</option>
					<option value="Feb2014">February 2014</option>
					<option value="Jun2014">June 2014</option>
					<option value="Oct2014">October 2014</option>
			</select>
			</td>
		</tr>
		<tr>
			<td colspan="3"><input type="radio" name="program" id="DE"
				value="DE" onclick="setUpMSProgram(this,'entry');" />DE Program
				(all courses taken via Distance Education). <br />&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Only
				open to International students residing outside of the US. (No F-1
				visa, no entry to the US)</td>
		</tr>

		<tr>
			<td colspan="3"><h5>How Did You Learn About the Program?</h5></td>
		</tr>
		<tr>
			<td colspan="3"><h4>MUM Agent</h4></td>
		</tr>
		<tr>
			<td colspan="3">If you learned about this program from one of
				our authorized agents, you will receive a tuition reduction of
				US$100, which will reduce the Computer Professionals Loan when you
				start your practical training work. To receive the tuition
				reduction, contact the agent for the applicable code and enter it
				here:</td>
		</tr>
		<tr>
			<td align="center" colspan="3">Agent Code <input type="text"
				name="agentCodeUser" id="agentCodeUser" size="30" maxlength="30"
				onblur="validateCode('Agent');" value="${personalInformaion.agentCodeUser }"/> <input type="hidden"
				name="agentCode" id="agentCode"  />
				<div id="agentCodeErrorDiv" />
			</td>
		</tr>
		<tr>
			<td align="center" colspan="3"><i> Agents are not official
					representatives of Maharishi University of Management. The
					University does not make recommendations concerning agents and the
					value of services they may render. Applicants must decide for
					themselves if they wish to use and pay for the services of an
					agent. </i></td>
		</tr>
		<tr>
			<td colspan="3"><h4>Other Source</h4></td>
		</tr>
		<tr>
			<td align="center" colspan="3">Source : <select name="source"
				id="source" style="width: 210px"
				onChange="selectOtherSource(this,'otherSource');"
				onclick="this.style.backgroundColor = '#ffffff';">
					<option value="none">Please Select</option>
					<option value="MUM-Student">MUM Student</option>
					<option value="MUM-Alumni">MUM Alumni</option>
					<option value="MUM Agent">MUM Agent</option>
					<option value="MUM Email">MUM Email</option>
					<option value="MUM Website">MUM Website</option>
					<option value="Friend">Friend</option>
					<option value="africajobsite.com">africajobsite.com</option>
					<option value="akhtaboot.com">akhtaboot.com</option>
					<option value="alumni.net">alumni.net</option>
					<option value="bayt.com">bayt.com</option>
					<option value="BEST">BEST</option>
					<option value="bestjobs.md (ONREA)">bestjobs.md</option>
					<option value="bestjobs.ro (ONREA)">bestjobs.ro</option>
					<option value="Bestjobskenya.com">Bestjobskenya.com</option>
					<option value="brainbench.com">brainbench.com</option>
					<option value="careerjet.com">careerjet.com</option>
					<option value="Camhr.com">Camhr.com</option>
					<option value="egyptitjobs.com">egyptitjobs.com</option>
					<option value="facebook">Facebook</option>
					<option value="facebook Ad">Facebook Ad</option>
					<option value="Google">Google</option>
					<option value="Google Ad">Google Ad</option>
					<option value="GRE">GRE/ets.org</option>
					<option value="GulfTalent.com">GulfTalent.com</option>
					<option value="hh.ru (ONREA)">hh.ru</option>
					<option value="jobs.bg (ONREA)">jobs.bg</option>
					<option value="jobs.cz (ONREA)">jobs.cz</option>
					<option value="jobdb.com">jobsdb.com</option>
					<option value="Jobs-eg.com">jobs-eg.com</option>
					<option value="Jobsinegypt.com">jobsinegypt.com</option>
					<option value="jobstreet.com">jobstreet.com</option>
					<option value="learn4good.com">learn4good.com</option>
					<option value="Linkedin">Linkedin</option>
					<option value="Linkedin Ad">Linkedin Ad</option>
					<option value="LMC">LMC</option>
					<option value="Mustakbil.com">Mustakbil.com</option>
					<option value="moj-posao.net">moj-posao.net</option>
					<option value="naukri.com">naukri.com</option>
					<option value="naukrinews.com">naukrinews.com</option>
					<option value="rabota.ua (ONREA)">rabota.ua</option>
					<option value="Yahoo">Yahoo</option>
					<option value="other">Other</option>
			</select>
			</td>
		</tr>
		<tr>
			<td align="center" colspan="3">If 'Other': <input type="text"
				name="otherSource" id="otherSource" disabled
				style="background-color: #e0e0e0;" class="text" maxlength="40" 
				value="${personalInformaion.otherSource }"/>
			</td>
		</tr>

	</table>
	<div align="right">
			<table class="buttons">
				<tr>
					<td>
						<input value="save" type="submit" id="personalS">
					</td>
					<td>
						<input value="next" type="button" id="personalN">
					</td>
				</tr>
				<tr>
					<td colspan="2"><div id="savePersonalInformation"></div></td>
				</tr>
			</table>
			</div>
</form>
